A 26-Year-Old Woman with Chronic Pelvic Pain and Negative Work-Up

In: Office Gynecology · 2019 · pp. 13–15 · doi:10.1017/9781108227469.006 · W2916100686
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This chapter presents a case study of a 26-year-old woman experiencing chronic pelvic pain despite a negative work-up.

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This chapter from “Office Gynecology” presents a case-based approach to pelvic pain, focusing on a specific 26-year-old woman with chronic pelvic pain and a negative work-up. The high-level method is descriptive rather than experimental, using the clinical narrative to illustrate diagnostic evaluation outcomes and subsequent clinical thinking within a pelvic pain framework. The key finding is that chronic pelvic pain can persist even when the standard work-up does not identify an underlying cause, emphasizing the challenge of unexplained pain syndromes in gynecology; the main limitation is that it is a single-case discussion with no systematic data collection or outcomes. The chapter is not specifically about endometriosis, but it is included in the corpus of endometriosis and adenomyosis research because it appears within a pelvic pain section that also contains a case explicitly about endometriosis (Case 6) and discusses chronic pelvic pain work-up in a condition-inclusive context.

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Office Gynecology Buy print or eBook [Opens in a new window] A Case-Based Approach - Office Gynecology - Office Gynecology - Copyright page - Contents - Contributors - Preface - Section I Pelvic Pain - Case 1 A 27-Year-Old Woman with Recurrent Visits for Severe Pelvic Pain - Case 2 A 25-Year-Old Woman with Deep Dyspareunia - Case 3 A 16-Year-Old Adolescent with Ongoing Dysmenorrhea Despite Oral Contraceptive Pill Use - Case 4 A 37-Year-Old Woman with Pain at the Lateral Aspect of Her Pfannenstiel Incision - Case 5 A 26-Year-Old Woman with Chronic Pelvic Pain and Negative Work-Up - Case 6 A 30-Year-Old Woman with Endometriosis with Worsening Pelvic Pain Despite Continuous Oral Contraceptives - Case 7 A 47-Year-Old Woman with Severe Menstrual Cramps and Painful Intercourse - Section II Vaginal Discharge and Sexually Transmitted Infections - Section III Amenorrhea and Abnormal Vaginal Bleeding - Section IV Contraception and Abortion - Section V Breast Problems - Section VI Cancer Screening and Prevention - Section VII Vulvar Disease - Section VIII Infertility - Section IX Preconception Planning - Section X Pediatric and Adolescent Problems - Section XI Pelvic Masses and Cysts - Section XII Incontinence and Prolapse - Section XIII Behavioral, Sexual, and Social Health - Section XIV Managing and Aging - Index - References from Section I - Pelvic Pain Published online by Cambridge University Press: 20 February 2019 Book contents - Office Gynecology - Office Gynecology - Copyright page - Contents - Contributors - Preface - Section I Pelvic Pain - Case 1 A 27-Year-Old Woman with Recurrent Visits for Severe Pelvic Pain - Case 2 A 25-Year-Old Woman with Deep Dyspareunia - Case 3 A 16-Year-Old Adolescent with Ongoing Dysmenorrhea Despite Oral Contraceptive Pill Use - Case 4 A 37-Year-Old Woman with Pain at the Lateral Aspect of Her Pfannenstiel Incision - Case 5 A 26-Year-Old Woman with Chronic Pelvic Pain and Negative Work-Up - Case 6 A 30-Year-Old Woman with Endometriosis with Worsening Pelvic Pain Despite Continuous Oral Contraceptives - Case 7 A 47-Year-Old Woman with Severe Menstrual Cramps and Painful Intercourse - Section II Vaginal Discharge and Sexually Transmitted Infections - Section III Amenorrhea and Abnormal Vaginal Bleeding - Section IV Contraception and Abortion - Section V Breast Problems - Section VI Cancer Screening and Prevention - Section VII Vulvar Disease - Section VIII Infertility - Section IX Preconception Planning - Section X Pediatric and Adolescent Problems - Section XI Pelvic Masses and Cysts - Section XII Incontinence and Prolapse - Section XIII Behavioral, Sexual, and Social Health - Section XIV Managing and Aging - Index - References - Type - Chapter - Information - Office GynecologyA Case-Based Approach, pp. 13 - 15Publisher: Cambridge University PressPrint publication year: 2019 Latthe, P, Latthe, M, Say, L, Gulmezoglu, M, Khan, KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health 2006;6(6):177.Google Scholar Reiter, RC. A profile of women with chronic pelvic pain. Clin Obstet Gynecol 1990;33(1):130–136.Google ScholarPubMed Mathias, SD, Kupperman, M, Liberman, RF, Lipschutz, RC, Steege, JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996;87(3):321–327.Google Scholar Howard, FM. The role of laparoscopy in the chronic pelvic pain patient. Clin Obstet Gynecol 2003;46(4):749.CrossRefGoogle ScholarPubMed Swank, DJ, Swank-Bordewijk, SC, Hop, WC et al. Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet 2003;361(9365):1247.CrossRefGoogle ScholarPubMed Price, J, Farmer, G, Harris, J et al. Attitudes of women with chronic pelvic pain to the gynaecological consultation: a qualitative study. BJOG 2006;113(4):446.Google Scholar Carey, ET, Till, SR, As-Sanie, S. Pharmacological management of chronic pelvic pain in women. Drugs 2017;77: 285–230.CrossRefGoogle ScholarPubMed Dowell, D, Haegerich, TM, Chou, R. CDC guidelines for prescribing opioids for chronic pain–United States, 2016. MMWR Recomm Rep 2016;65(RR-1):1–49.CrossRefGoogle Scholar Sharma, N, Rekha, K, Srinivasan, JK. Efficacy of transcutaneous electrical nerve stimulation in the treatment of chronic pelvic pain. J Midlife Health 2017;8(1):36–39.Google Scholar Arnouk, A, De, E, Rehfuss, A et al. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep 2017;18:47.Google Scholar Lamvu, G. Role of hysterectomy in the treatment of chronic pelvic pain. Obstet Gynecol 2011 May;117(5):1175–1178.Google Scholar Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. 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chronic_pelvic_pain

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